Determining a spatial relation between an upper jaw and a lower jaw for edentulous patients and determining a spatial relation between the upper jaw and the lower jaw with reference to their temporomandibular joints (TMJs) are challenging tasks in dentistry. A temporomandibular joint (TMJ) is a hinge joint that connects the lower jaw or mandible to the temporal bone. Typically, in a dental prosthesis, an average TMJ location is used to determine a three-dimensional (3D) relation between the upper jaw and the lower jaw. The 3D relation between the upper jaw and the lower jaw with reference to the TMJs of a patient with natural dentition is utilized in many dental treatments, for example, in an orthodontic treatment, pediatric dentistry, restorative dentistry, and in airway management appliances. During an orthodontic treatment, improper tooth movement may result in displacement of the TMJ. In pediatric dentistry, the positions of the upper jaw and the lower jaw with reference to the TMJs are monitored during development of the upper jaw and the lower jaw. In restorative dentistry comprising, for example, crown restoration, bridge restoration, implant supported restoration, etc., cusp inclinations of prosthetic teeth are determined by the location of the TMJs with reference to the upper jaw and the lower jaw. In an air way management treatment, the advancement of the lower jaw is considered along with the 3D location of the TMJ to avoid TMJ displacement.
In an edentulous patient, after a clinical impression of an upper ridge of the upper jaw and a lower ridge of the lower jaw is taken, a customized bite rim has to be fabricated to determine the relation between the upper jaw and the lower jaw. In the case of partially edentulous patients, there is a need for a customized bite shaped member for accurately determining locations where teeth are missing and also for determining the relation between the upper jaw and the lower jaw. The size of the oral cavity of the mouth differs from person to person and careful considerations must be given in order to estimate a vertical distance between the upper jaw and the lower jaw. Therefore, there is a need for different types of bite frames and mesh elements or bite shaped members of configurable shapes with channels separated by different vertical distances for receiving a bite registration material for registering a bite impression and thereafter determining a relation between the patient's temporomandibular joints (TMJs) and the upper jaw and the lower jaw.
Conventional procedures for determining three-dimensional (3D) information of the upper jaw, the lower jaw, and the temporomandibular joints (TMJs) comprise, for example, obtaining an intra oral impression of a coronal portion of the teeth, capturing tomographic images of the upper jaw, the lower jaw, and the TMJs at a focal point from a panoramic X-ray, etc. There is a need for accurately determining the 3D relation between the TMJs and the upper jaw and the lower jaw using the 3D information. In dental panoramic images, most of the distortion, magnification, and minimization are in the horizontal dimension, while the vertical dimension remains accurate. Therefore, there is a need for correcting the horizontal dimensions according to reliable markers to allow the use of panoramic images of the upper jaw, the lower jaw, and the TMJs of the patient for identifying the accurate locations of the upper jaw and the lower jaw with reference to the TMJs.
Hence, there is a long felt but unresolved need for a bite registration apparatus comprising a bite frame and a mesh element or a bite shaped member of configurable shapes with channels separated by different vertical distances for registering a bite impression in edentulous patients and partially edentulous patients, while considering vertical distances between the upper jaw and the lower jaw. Furthermore, there is a need for a method that employs the bit registration apparatus and an image processing system to determine a three-dimensional (3D) relation between the upper jaw and the lower jaw of a patient with reference to the patient's temporomandibular joints (TMJs) using 2D and 3D panoramic X-ray images, 3D scanned images, and 3D head surface images.